title: Bone scintigraphy and radiolabeled white blood cell scintigraphy for the diagnosis of mandibular osteomyelitis.
abstract: The aim of this study was to evaluate the diagnostic efficacy of bone scintigraphy (BS) and radiolabeled white blood cell scintigraphy (WBCS) in detecting septic activity in the flat bones of the jaw. A retrospective analysis was conducted using 38 studies of combined BS plus WBCS: 33 of them 3-phase BS and 36 of them 2-phase WBCS. These studies were performed on 34 patients, 19 women and 15 men with a mean age of 56 years (22-79), who presented with suspected mandibular osteomyelitis, either acute or chronic exacerbation. The results were compared with histologic findings (55%) or with a minimum clinical/radiologic follow-up of 6 months (average, 21 months), when biopsy results were not available. BS showed a sensitivity of 100%, a specificity of 6.7%, a positive predictive value of 62%, and a negative predictive value of 100%. For WBCS, the corresponding values were as follows: 73.7%, 78.6%, 82%, and 69%. Accuracy was 63.2% for BS and 94.7% for WBCS. WBCS has proven to be a useful test for detecting septic activity in the jaw bone, being more effective than BS alone, which under certain circumstances, can return a very high false-positive rate.
authors.affiliation: Nuclear Medicine, Hospital Universitari Vall d'Hebron, Department de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain. mariaboronat@gmail.com
authors.forename: María
authors.initials: M
authors.lastname: Boronat-Ferrater
authors.forename: Marc
authors.initials: M
authors.lastname: Simó-Perdigó
authors.forename: Gemma
authors.initials: G
authors.lastname: Cuberas-Borrós
authors.forename: Santiago
authors.initials: S
authors.lastname: Aguadé-Bruix
authors.forename: Fiorella
authors.initials: F
authors.lastname: Dellepiane-Clarke
authors.forename: Elia
authors.initials: E
authors.lastname: Torrent-Llongarriu
authors.forename: Montserrat
authors.initials: M
authors.lastname: Negre-Busó
authors.forename: Francisco
authors.initials: F
authors.lastname: Porta-Biosca
authors.forename: Manel
authors.initials: M
authors.lastname: Sáez
authors.forename: Joan
authors.initials: J
authors.lastname: Castell-Conesa
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007553:Isotope Labeling; D007962:Leukocytes / Q000000981:diagnostic imaging*; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging*; D008336:Mandibular Diseases / Q000097:blood* / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010019:Osteomyelitis / Q000097:blood* / Q000000981:diagnostic imaging*; D011877:Radionuclide Imaging; D012189:Retrospective Studies; D013997:Time Factors; D055815:Young Adult